Institute of Cardiovascular Sciences, Cardiology Division, Department of Physiology, University of Manitoba, Winnipeg, Manitoba, Canada.
Resuscitation. 2013 Jul;84(7):878-82. doi: 10.1016/j.resuscitation.2013.01.038. Epub 2013 Feb 18.
Since the introduction of telemetry over a half century ago, it has expanded to various units and wards within health care institutions outside of the traditional critical care setting. Little is known on whether routine telemetry use is beneficial in this patient population. The aim of this study was to determine the impact of telemetry monitoring on survival of in-hospital cardiac arrests in patients admitted to non-critical care units.
A retrospective study of cardiac arrests in patients admitted to non-critical care units within the Winnipeg Regional Health Authority from 2002 to 2006 inclusive was performed. Baseline demographic, cardiac arrest, and outcome data were collected.
Of the total 668 patients, the mean age was 70±14 years with 404 (61%) males. Patients presenting with asystole or pulseless electrical activity (PEA) demonstrated an increased mortality as compared to those presenting with ventricular tachycardia (VT) or ventricular fibrillation (VF). Overall, 268 of 668 patients (40%) survived their initial arrest, 66 (10%) survived to hospital discharge and 49 (7%) survived transfer to another facility. Patients on telemetry vs. no telemetry had higher survival rates immediately following cardiac arrest (66% vs. 34%, OR=3.67, p=0.02), as well as higher survival to hospital discharge (30% vs. 6%, OR=7.17, p=0.01). Finally, patients with cardiac arrest during the night and early morning benefited proportionally the greatest from telemetry use.
Regardless of whether cardiac arrest was witnessed or unwitnessed, telemetry use was an independent and strong predictor of survival to hospital discharge.
自半个多世纪前引入遥测技术以来，它已经扩展到医疗机构的各个单位和病房，超出了传统的重症监护环境。对于在这种患者人群中常规使用遥测技术是否有益，知之甚少。本研究旨在确定在非重症监护病房住院的患者中心脏骤停时进行遥测监测对存活率的影响。
对 2002 年至 2006 年期间温尼伯地区卫生局非重症监护病房住院的心脏骤停患者进行回顾性研究。收集了基线人口统计学、心脏骤停和结局数据。
在总共 668 名患者中，平均年龄为 70±14 岁，其中 404 名（61%）为男性。与出现室性心动过速（VT）或心室颤动（VF）的患者相比，出现心搏骤停或无脉电活动（PEA）的患者死亡率更高。总体而言，668 名患者中有 268 名（40%）在首次心脏骤停后存活，66 名（10%）存活至出院，49 名（7%）存活至转至其他机构。与无遥测的患者相比，接受遥测的患者在心脏骤停后即刻的存活率更高（66%对 34%，OR=3.67，p=0.02），以及出院时的存活率更高（30%对 6%，OR=7.17，p=0.01）。最后，夜间和清晨发生心脏骤停的患者从遥测使用中获益最大。
无论心脏骤停是否有目击者，遥测使用都是出院时存活的独立且强有力的预测因素。
